Provider Demographics
NPI:1326659459
Name:ROBINSON, MARVIN B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:B
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SHAGBARK DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-9352
Mailing Address - Country:US
Mailing Address - Phone:662-609-7522
Mailing Address - Fax:
Practice Address - Street 1:105 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2351
Practice Address - Country:US
Practice Address - Phone:662-563-2855
Practice Address - Fax:662-563-2844
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-094421835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist